Studying 'aberrant behavior' differences in prescription opioid misuse by men and women

Abuse of prescription opioid (PO) medications is on the rise. Commonly abused POs include oxycodone (e.g., OxyContin, Percocet) and hydrocodone products (e.g., Lortab, Vicodin). Recent data from a large (N = 91,823) study estimates that 10 million individuals have used POs non-medically in the past year.

Patients prescribed opioids often display one or more “aberrant” behaviors, such as requesting early refills or borrowing medication from friends and family members. Due to the concerns that these behaviors raise among health care professionals, several studies conducted at MUSC by Drs. Sudie Back, Kathleen Brady, Rebecca Payne, Arthur Smith and Scott Reeves have further investigated the misuse of opioids. Results from these studies suggest that there are significant differences between men and women with regard to the type of aberrant behaviors displayed and what predicts PO misuse. For example, among 121 chronic pain patients, women were more likely than men to save unused POs; this is of concern because these unused medications are often left unsupervised (e.g., in a medicine cabinet) and within reach of others, including children. Women were also more likely to take POs in combination with other prescription drugs in order to enhance the desired effects; this is particularly dangerous given the potential for drug interactions and accidental overdose. Men were more likely than women to administer opioids through alternative routes than prescribed; examples of these alternatives include crushing, snorting, and injecting pills, which can be extremely dangerous.

Further study is needed to determine whether or not aberrant PO behaviors (e.g., asking for early refills or borrowing medication) predict the later development of an opioid use disorder and/or other harmful effects, as well as if these predictors are gender-specific. It is also important to find methods to identify “at risk” patients and to develop effective interventions to disrupt the progression from misuse to dependence.

Dr. Sudie Back is currently enrolling adults with and without prescription opioid dependence in a study investigating the link between response to stress and PO use. If you would like to take part in the study or would like more information about the study you can call Nicole at 792-0236.